Provider Demographics
NPI:1306097597
Name:JONSON HUANG MD INC
Entity type:Organization
Organization Name:JONSON HUANG MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONSON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-259-5409
Mailing Address - Street 1:1626 WILCOX AVE
Mailing Address - Street 2:641
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-6234
Mailing Address - Country:US
Mailing Address - Phone:316-259-5409
Mailing Address - Fax:
Practice Address - Street 1:250 N ROCK RD
Practice Address - Street 2:300D
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2203
Practice Address - Country:US
Practice Address - Phone:316-259-5409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-190912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty